Well with Arielle Lorre - 165: Wellness and Chiropractic Myths + Cracking Down on Minsinformation with Aaron Kubal, DC

Episode Date: April 6, 2022

In this episode, I'm talking to Aaron Kubal @aaronkubal, a board certified Chiropractor and staunch advocate for evidence-based care. He calls out the common misconceptions of his field, like the actual effects of those viral back cracking videos, to musculoskeletal manipulation in adults AND babies; why treatments that don't actually do anything feel like they work; more general health misconecptions surrounding injury, stretching, posture and pain; the efficacy of various wellness trends, and so much more.   Sponsors: Ritual.com/BLONDE for 10% your first 3 months Talkspace.com code BLONDE for $100 off your first month Curology.com/BLONDE to start your free 30 day trial Sakara.com/BLONDEFILES20 for 20% off your order   Produced by Dear Media.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

The following podcast is a dear media production. Hey, welcome to the Blonde Files podcast. I'm your host, Ariel Lorry, and I'm here to talk all things wellness. From how to achieve optimal health and well-being to the best beauty tips and everything in between, no topic is off limits, and I'm bringing it to you real and unfiltered. I know there is so much information out there, so I'm here to help you navigate it all. Thanks for listening. Let's get into it. Hi everybody. Welcome to this show. I'm laughing because I feel like I need to have a better intro to this podcast. I say the same thing every week. But I hope everyone is doing well. I have a really interesting episode for you guys today. At least I found it to be super fascinating. It's a pretty raw and honest discussion about like healthcare in the wellness world and misinformation and scope of practice. And I feel like some people will have.

some strong thoughts about this. And my guest really doesn't hold back, which I find to be refreshing, but I'm sure it will cause some people to have some reactions. But I think it's important to listen all the way through to the end because ultimately, I think the takeaway from this episode is to find what works for you, which will be different for everybody, but to also be skeptical and wary when it comes to a lot of things in the wellness world. So I am talking to Aaron Kubal, I found him through a past guest of mine, Dr. Danielle Ballardo, who I love, and I know a lot of you guys are probably familiar and love her as well. So Aaron is a board certified chiropractor with special interests in rehabilitation and chronic pain, and he utilizes education

and exercise and delivers patient-centered care that's unique to each individual. He works with all under the umbrella of evidence-based practice, of which he is a staunchy, advocate, which you're going to hear in this episode. He prioritizes self-management and patient empowerment so that he can serve as a guide while patients work towards their goals. And that's also kind of another theme of this episode. And we also talk about common misconceptions in his field, like the actual effects of backcracking and adjustments and all those viral backcracking videos to like spinal manipulation in adults and babies, the efficacy of this. We talk about general health misconceptions. We talk about injury, stretching, posture, pain, a lot of other trendy wellness

treatments, and so much more. So I hope you enjoy the episode. Welcome, Aaron. Good to be here. It's nice to meet you, too. I know. I feel like we've been following for a little bit. I can't remember how I found you. I think it was probably through Danielle, Dr. Bellardo. And I've been enjoying your content ever since. I really love people who are kind of like irreverent in their field. Kind of like, I'm not irreverent, but you're a little bit, what's the word I'm looking for? Irreverent. Yeah, I guess we'll stick with that one. But I feel like, you know, we'll get into your background and all of that.

But the field of like chiropractors, kind of having a moment right now more so than ever maybe because of social media and the wellness world and TikTok and these viral like backcracking videos and all of that, which we'll get into. And if you guys could see this, you would see Aaron shaking his head. So I can't wait to get into all of this with you. and do some like debunking and hear from, you know, kind of an adult voice in the room. But to start, why don't you just tell everybody a little bit about who you are and what you do? I'm Aaron. I'm a chiropractor. I do a lot of social media stuff. And that's pretty much it. My actual work, I have my own online telehealth practice. I work primarily with patients dealing with chronic pain. I've been doing that now for a year and a half. Super awesome. I get to, you know, co-manage

with some good pain clinics around the United States and some good orthopedic centers. And social media has created a lot of those kind of cool opportunities for me as far as telehealth, especially just because people think chiropractor, they think hands-on, backcracking. They don't usually imagine me treating every single patient through a computer screen. I don't even take patients in person.

But fortunately enough for me, this whole TikTok and Instagram thing kind of fell into my lap. And I was able to start my own online practice and do things kind of the way that I wanted to do them. So I get to be a little non-conventional. not only in how I approach chiropractic from a social media perspective, but also how I literally practice it through a computer screen. So kind of a different way of doing things, I suppose. I feel like probably everybody listening right now, it's like, how are you a chiropractor

remotely? Because I think when people think chiropractor, they think what we see, which is readjustments and these very like hands-on manipulations. How and why did you get into the field? and then maybe like tell us a little bit about how do you actually practice remotely? What kinds of things are you doing? Yeah. So I got into it just because when I was young, a multi-sport athlete and, you know, just aches and pains with that kind of thing come and go. So we had like a family friend who was a Cairo.

And when I saw him, like he took a kind of similar approach to the one I take right now currently, which is there wasn't a whole lot of like weird voodoo shit. It was like pretty, pretty. none of it seemed strange to me. And I really liked how he approached care. A lot of it was just advice and kind of just teaching me what to do in a lot of different pain and injury situations. And then sometimes he'd use exercise.

Sometimes he'd crack my back. But like a lot of it was just him teaching me like how to take care of myself, which I thought was really cool. And I just assumed erroneously that that's what all chiropractors did because I just didn't know any better. And me and my assumptions, I took those all the way to literally go into chiropractic school. and at no point was like, maybe I should look more closely into this before making a career of it. So I'm kind of naive and ignorant on my behalf, but then I got into chiropractic school,

expecting to see a lot of what he had been doing, and then found out that he was the vast minority, and there was a lot more to chiropractic that I didn't know about. And it just got weirder and weirder from there. And now my life is super weird. So that's how I got in. And then my approach to care, it is, it's entirely predicated on self-made. management. I think a lot of the clinical practice guidelines for managing pain in a lot of different conditions and a lot of different complaints, a lot of them tail around teaching people self-management,

teaching people how to be autonomous. And because I'd say 99% of musculoskeletal stuff can be effectively self-managed. If you just give people the skill set and you empower them and you teach them how to do it, they can really do a great job taking care of themselves. That's a lot of what I do is helping people with that. Can you talk a little bit about like what is within the scope of practice? Because I feel like there are there are so many chiropractors now who have, I won't name any names, but who are like big social media personalities and kind of media people who are like doctors so and so and they treat all kinds of things. But then you find out that they're a chiropractor. So what is within the actual scope?

Did you see my, did you see, I did a video like two days ago because somebody like made a comment where you knew you can reply to comments with the video stuff. And they were like, why are you so negative of the profession you represent? And I was like, why am I so negative? I don't know what there is to be positive about. And then I cited this paper that came out, I think like two, three weeks ago that they literally like analyzed back pain information on TikTok and just how evidence based and how much is that. the content supported by science, and they found that the back pain videos from chiropractors specifically were the most likely to be the least evidence-based and the least

scientifically oriented. So, like, that's the kind of thing where I just, like, when people ask what our scope is, I don't even freaking know. Because, like, we talk about the most random shit and our regulation is all over the place. Like, chiropractic is different in different countries, but in the United States, it's the wild, wild, wild. I've made jokes a bunch of times where it's like I, sometimes it seems like you can just do anything. Honestly, like, I mean, you see people treating cancer and ADHD and cardiovascular disease and then pain and then like, I mean, I've seen, I've seen claims for everything.

And I see, you know, chiropractors like cracking horses and lizards and shit. So like I honestly, I don't even know what we all can and can't do. I know that we have evidence supporting an approach to muscle. skeletal pain complaints and then literally no evidence to support anything beyond that

so that's what I consider our scope but obviously there are other chiropractors around social media who see our scope is quite a bit broader

so I don't know I guess I don't know what the hell it is well and I mean we can laugh but I think I heard you I think it was on Danielle's podcast as well that

maybe she said like the the field of chiropractors were huge kind of peddlers of misinformation, especially during the COVID pandemic. We're the best at it. We're so good at it. Yeah. And I remember too early on, because I was like this with the whole misinformation thing and, you know, calling out all the nonsense kind of stuff. Like I was doing that even as a student pretty loudly, honestly, to the point of where I would get in trouble for it.

And I remember when COVID first started, I was seeing everywhere chiropractors, even just in our local community and around the school, like chiropractor's making claims that backcracking could prevent COVID, which, I mean, what the fuck? Like, what a wild, what a wild claim to make. But they were making it. And it was insane. I was reporting people to our state board nonstop. And then I saw our state board do a post on their Facebook page, also saying that

backcracking could, you know, have a preventative effect for an immune boosting effect for COVID prevention. And I was like, the fucking board. So I made this crazy, like, pissing. off comments on there and got like calls from them the next day just laying into me for being like so brash and outspoken in a public forum and tell me that like it's not a Cairo who posts that it's just an unpaid intern blah blah blah you shouldn't freak out and I was like well I'm sorry I'm a little on edge you're like the eighth person I've called out this week for trying to prevent

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slash blonde. When they say mental health is a journey, they definitely mean it. This is why it's so important to prioritize your mental health and wellness every day, which I obviously talk about here on the podcast. And when you work on yourself, it brings positive changes in all areas. areas of your life. The long-term effects of therapy can give you the tools to deal with challenges as they arise to strengthen your relationships and give you a more positive outlook on life. And there's no better time to invest in yourself than right now. I, as you guys know, have been in and out of

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when really things were far from it. I was secretly battling anxiety, depression, and an eating disorder. So it was a lot. I'm Victoria Garrick, former division one athlete, mental health advocate, and host of RealPod. Every Wednesday, I sit down with celebrities, athletes, entrepreneurs, and more to talk about the inner thoughts and feelings that we're all struggling with. So leave the filters and face tunes at the door and join me on RealPod. Let's talk about the backcracking because I know in the wellness world, which is where my content and all that would fall under, readjusting, backcracking, is very heavily promoted. I feel like so many people, even that I'm friends with,

go to get readjusted all the time. They all have chiropractors. They're famous, you know, not famous, but like very celebrity-loved chiropractors here and eye that everyone goes to and they swear by it. So what can and can't backcracking and readjustment achieve? Oh, man, it's pretty unexciting what it can do. That's for sure.

First of all, we don't even get the name right because like adjustment. We call it an adjustment, but that implies that something is not the way it's supposed to be and that you're changing it into the way that it is supposed to be, obviously implying that the bone is not where it's meant to be or that it's not moving correctly or the vertebrae is stuck or whatever misaligned. And that's just not at all what happens. So like even the name doesn't make any sense. I always just call it spinal manipulation or cracky-backy.

but it doesn't change anything about anybody physically. And it's really, I think a lot of the positive effects that you see of people like reporting that they feel better or that they're getting pain relief or whatever it is, when we look at a lot of the research on trying to sift out what seems to be behind a lot of that, it seems like a lot of it has to do with contextual factors, which is basically saying how bought in was the patient to the treatment? and how much did they expect it to help them?

And like, how played up was it by the provider? How much should they trust the provider? Do they feel safe and listened to and all those things? Like, that stuff has a much more influential role in the outcome of the treatment than the treatment itself. And the reason that that we know that is because there have been trials that compare for like something like acute back pain, let's say. There's trials that compare all the most common back pain treatments, whether it's acupuncture or backcracking or. scraping techniques, massage, like all the big ones, exercise. And for like an acute case of back pain, so a new episode, they all follow kind of the same

pattern of improvement. And one of the things that they tested in comparison with those treatments is no treatment at all and placebo. Meaning that that tells us like if no treatment at all and placebo follows the same pattern of improvement of all those treatment groups, then maybe the outcome isn't unique to the treatment or a result directly in the treatment. Maybe it has much more to do with, one, the contextual factors, and then two, just the passage of time. That's another big one, too, because what a lot of people are not told by their health care providers,

chiropractors, physical therapists, but they should be. And I talk about this all the time, and I ranted about it on Danielle's podcast, too, is a lot of musculoskeletal conditions that people seek help for have a very favorable natural history, meaning they usually take care of themselves, whether you get treatment or not on their own, you know, within a matter of weeks at most. So a lot of the time when we look at, like, what's actually influencing outcomes, a lot of time it looks like it's just the passage of time. And the chiropractor kind of takes credit for time going by because they showed up in

week three of something that was going to get better in four weeks. Like, then it looks like they fixed it. But really, you just hit week four. That's a lot of what's going on there. I had a neck injury recently. And around week like two or three, I went to see a doctor. doctor and he said it's probably just going to shake out in the next few weeks and it did. But I can imagine how had I gone and had some other kind of like quote unquote intervention,

it would be easy to attribute that to the intervention. So I mean, if somebody is going to get spinal manipulation, if you will, I feel like it's benefiting them and they're having this placebo effect, is that harmful or what are your thoughts on that? I always am very adamant that I think any explanation that gives patients the impression that their body is fragile or flimsy is harmful. Even if it's small, even if they don't take it very seriously, I think we should never do that because the science does not support saying things like that. So narratives like that would be like, you know, that we can break up fashion, that we can realign your skeletal structure, that we can release your muscles or that we can, you know, like have these dramatic changes on your physical structure with just our. hands, those all kind of imply that like your body is so malleable to the touch that there's

barely anything holding you together. I think all of that stuff has the capacity to harm and a lot of it just depends on how serious the person's issue is and how seriously they take that. But I have nothing against backcracking as long as it's communicated honestly and with a more science-based perspective around. I mean, if I'm, if I were still offering that service, if I was doing that with patients, the way I would explain it to people if they wanted it was it would be, if you ever had a sore throat and you take a cough drop, when you take the cough drop, you don't expect it to cure the sore throat. You don't expect it to make the sore throat go away any faster. You expect it to take the edge off for 20, 30 minutes, maybe a little bit. That's pretty much

what backcracking can do. You felt one thing, I touched your back, put my hands on it, and pushed. Now you felt something else for a little bit. That's kind of its ceiling. of an effect and then its floor of an effect is just fucking nothing at all. Because there's a lot of people out there who it just straight up doesn't help too. You just don't hear from them because the people who tend to scream the loudest are the ones who feel like it was like a life-saving treatment for them, which there are people like that. And I think a lot of that has to do with, again, those contextual factors and the fact that they saw a provider who listened to them and is caring for them and is putting their hands on them

and trying to be a positive influence. Like, that can help people's pain, but there's an honest way to communicate those things. And we can have those patient interactions without making them think that, you know, we're holding their spine together or we're holding their fascia or muscles together and things like that. Yeah. And I've heard you say, like, if it were that easy to manipulate, kind of like what you were saying, that would imply that, like, we are so weak and malleable, which is a little frightening. I can tell you another outcome that can happen because this is what happened to me. And this is not to say that I have anything against chiropractors, but when I got sober, eight years ago, I went to rehab. And at that time, I was very ill, very malnourished.

I've been, like, living off alcohol, not eating. You know, I'm sure, like, my bones were very brittle or something. I don't know. And I had fallen a lot before I got sober. And I went to rehab, and I had really bad back pain. And they said, well, why don't you go to a chiropractor and get readjusted? And I went, and there were no, like, there was no physical exam. no history taken nothing.

I stuck. I crack my back. And when I say it was the worst fucking pain I've ever had, it felt like all of my ribs were breaking. And I remember leaving and I was like something is not right. Like it was so hard to breathe. It felt like everything was out of place. Finally, it got unbearable that night.

I had to go get x-rays and I had a fractured spine in three places. Oh, God. Oh, I don't know if that was. And it was like, well, was that from falling when I was like blackout drunk and I was having seizures all the time or was I just really weak and I already had these injuries and then we did the crack and that was just you know who knows. But see even then like in an instance like that like it should have just it should never even come to that because if you go through like a proper patient history then that person would

know that you're in a place where you're in the middle of recovery and you've had a fall history and seizures and things like that and like there's possibility of like traumatic injury and and all of those different things. And you look at that history and be like, maybe spinal manipulation, this borderline, pointless treatment isn't something that you even need right now. I don't think we need to push on this. Like, it's just, that's just so crazy to me.

And that should tell people, too, like, if you're in an office like that, like how impactful can an intervention really be? If there's some offices out there that are delivering it without doing like a proper history or without doing a proper exam, and they're just kind of throwing it on there and cracking you. Like, I mean, people, people do it like it's a party trick because that's kind of where the value of it is at a lot of, to be completely honest. Like, to tell you the truth, the only time I do it these days after not doing it for a year

and a half since I graduated is when I'm like out drinking with my friends and they want to learn how to do it. So I teach them how to do it to each other. Like I literally treat it like a party trick at this point. That should tell people, like, if chiropractors feel like they can be that flimsy within, just kind of throw it around to whoever without even taking them through a proper history and vetting the situation, like, it's probably not something that's that impactful and potentially harmful.

Yeah. In these TikTok videos and viral Instagram videos and everything, what is actually happening? Like, what are we hearing and seeing? I've done video breakdowns of some of the really big ones. I know everybody's seen like the kid where he's like all hunched over. And then by the end of the video, he's standing up straight. And, you know, I've broken those down. And the truth is, like, when you watch them, obviously with those videos, you know,

there's a lot that you don't see. And they choose what gets put in them and they're edited by them. It's not exactly, you know, a reliable case report. But it is all explainable. And like a lot of the time when you watch it, it has a lot to do with what goes on in between. Like, like for the one I'm even referencing right. right now where the kids like doubled over. Like you watch them and in between adjustments,

getting up and walking around and he's trying to stand himself up against the wall and he's starting to move into the position they're trying to get him into. And he's getting positive reinforcement and encouragement from the guy who's taken care of him and telling him like, it's okay to poke into pain a little bit. It's okay to straighten your back out after he had been very avoidant and very fearful of moving us back at all because of how sensitive it is.

Like when somebody gives you that sort of reassurance and those guardrails to start trying to poke into things and move a little different. I can see outcomes and changes like that because back pain can be pretty intense and really freak people out. So, you know, it's always different. And again, you never really have the full story. But usually when you watch those videos, it is very explainable what's going on. And usually it's nothing unique or special about the backcracking. It's usually more context stuff that people really don't pay a lot of attention to.

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but there are things that I've seen you talk about and there was one that I actually posted about that you're responding to. You know which one I'm talking about? Legs up on the wall. Oh, is that legs up on the wall? What was that for, though? So legs up on the wall. And I actually got a lot of pushback from this. So I did it. I was in a sauna. And I've had people who have said, oh, put your legs up on your wall. Like it'll help circulation. It will help bloating. It helps your nervous system, various things. And you were like, it doesn't do anything. Oh, that's right. Yeah, no, I remember.

Yeah, no, I just, like, I think people, you know, like a lot of these physiologic processes, like, a lot of them are really, really simple and they can be achieved in like a wide variety of ways. Like, like, so like increase in circulation. Like I can increase the circulation to my bicep just by going like this 10 times, you know, because I'm moving in. Blood goes to the areas that you're, you know, given some action to. So a lot of them, when people understand just kind of like the underlying mechanisms for things like that, It's just usually not that exciting. Like, a good example that you see in some videos is, like, big changes in, like, range of motion. Like, with after backcracking videos, they'll be like, oh, I can go so much farther. But what people don't understand is with your nervous system, anything can change range of motion, literally anything. I might even be able to change your range of motion, like, through the computer screen. That's how easily tricked our nervous system is. And what I mean is people usually think about range of motion.

Like, it's all about tight muscles and rest of the brain. restricted and tight joints and they think it's all purely structural, but a lot of it, how far you can go into any range, has a lot to do with stretch tolerance, the feeling of stretch, which is a nervous system thing. And stretch tolerance changes, the more you expose yourself to whatever range of motion you're pushing into. So like, if I'm stretching my shoulder this way, the more I do it, the greater my tolerance is for my shoulder going that way. It just gets used to it. It's like putting your toe into a hot tub and just easing your way in gradually. That's kind of the same thing that happens with this range of motion stuff. So when you watch people do that,

you know, let's say somebody turning their head one direction when they couldn't go very far before. I have them go this way and try to poke into it a couple of times and they don't go very far. And I have them do like two, three reps, whatever. And then I could, you know, play the bongos on their head and freaking blow on their forehead or whatever, do something stupid, snap my fingers and then have them try it again. And because they just got three reps of pushing into it before, that and they're also now expecting, because I played it up a little bit, that they'll go further, they'll probably push a little bit further and feel like they can go farther. So it's a lot of those things are really easily manipulated and it's usually not anything too exciting or crazy when you

look a little closer at it. I mean, it's like when you stretch before you work out versus when you stretch after, right? Sure. Yeah. I mean, like that's a good one too. So like the stretching like warm up before and after workouts. Like I always tell people, like you really don't need to do any stretching before a workout or before lifting weights because like what is the whole point of a warm up? If I want somebody to warm up before doing a session of squats,

I'll just tell them do five air squats, do five squats with the bar on your back, put a little bit of weight on and then go. So all you have to do to warm up to do something is just do the thing really low intensity and then build. But like laying around on a foam roller or like doing a whole bunch of random hip stretches, which I always hate, like the videos of the big long mobility routines,

because we have such a big problem with people meeting physical activity guidelines in this country because time constraints and jobs and things. We're not helping people when we tell them that you need to add a 20-minute stupid fucking mobility routine to your workout. And they're like, well, how am I supposed to get everything done? I got a 60-minute workout and I got a 30-minute mobility routine. I got to cool down after and I got to drive to and from. It's like, we're really overcomplicating this.

for people and a lot of a lot of the stuff that we make them think their bodies need to go through in order to be able to be safe and do the things they want to do a lot of is just really not necessary I saw you had a great video on exercise I think it was something like the rule of twos do you remember that oh yeah yeah yeah too much too soon after too little for too long that being one of the bigger factors and injury yeah yeah like no peaks and valleys right that I mean and like this that's another one where it's like everybody's like, oh, technique and proper form and all this stuff with weightlifting and people obsess. They obsess over like, keep my back straight and like all these rules don't let your don't have a butt wink when you squat and don't go knees over

toes. Don't let your knees cave in. Don't let your feet go flat. Like there's all these arbitrary rules that are based on nothing. There's no evidence that any of them are predictive of injury or that any of them are higher risk than than anything that is proposed is safer. And when you look at what does seem to be more strongly correlated with injuries, it is that whole, like, the idea of people just doing too much too soon after too little for too long, or you can even take out the second part and just say too much too soon, lack of preparedness. The peaks and valleys I like talking about a lot because people fall into the cycle with

pain and injury stuff where like they get pain, they get a flare up, and people always equate pain with damage, which it's not a sign of. And so they'll avoid activity and they'll take a long. long rest period and that kind of can create that valley and then they'll re-insert themselves into activity without easing back in and just assume that it can get started again, that can kind of create the peak. And that's another kind of thing we see with like with re-injury stuff. I mean, it's crazy because it's a lot simpler, but it's also a lot more pragmatic and useful than a lot of the like movement rules that are placed on people about there's only one right,

safe, correct way to do it. And if you're doing it wrong, you're, you're going to hurt yourself. It can be a lot more simple for people, but we do a good job of making it overly complicated. Well, simple isn't sexy. No, it's not. And that's why I'll never find my girlfriend making TikTok videos because I talk about all the boring shit and then yell at everybody. I mean, while everybody else is out here cracking backs with their shirt off and they got the chicks on the table and they're doing the fun treatments and making the big claims. I'm over here my dorky research papers behind me saying, no, that doesn't work either. it's not fair it's not fair

can you talk about how you said pain doesn't mean that there's damage can you explain that yeah that's that's huge i mean that's that's like one of the biggest guiding principles that we need people to know a lot more about um because people do tend to still on a societal level equate pain with with tissue damage but we've known for a really long time um just in in musculoskeletal pain research that that's that's not true and there's a million in examples of this. I mean, you know, some of the easiest ones, like you hear about disc bulges, disc herniations, you know, joint degeneration, things like that. And when you scan people and you look and see who has them and who doesn't, it's not that strongly associated with back pain.

People always think, like, if you've got a disc bulge, you've got a discurneation, your back's going to be in agony. But we see those things in people who are entirely pain-free as well. And then even like pathology at other areas, two different joints. We look at rotator cuff tears, labral tears, ACL tears, meniscus tears, ligament tears, and ankles, things like that. Like you see these things in people who are pain free and are completely unaware that they even have them. And they don't even influence their function or anything or their strength. And all that is to say is like pain is a lot more complicated than just tissue damage.

You know, at most it can be a small control. contributing factor, but it can never be like the whole thing unless there's like a traumatic tissue injury like you got shot. Like yes, then pain is strongly correlated with tissue damage. But even then it's not because you still hear about those stories of like people getting shot but not knowing it until they got to safety in like a war or something like that. And you know, you see even much more benign and simpler instances like how many times have you ever noticed a bruise and been like, where did that come from a bruise is tissue damage and if pain was always strongly correlated with damaged tissues you should feel all those and know when you get them like you think about headaches like nobody says

that when you have a headache that you have a damaged skull or a damaged brain people who understand that one that's more about sensitivity and it's more about a broad spectrum of contributing factors and we should probably be looking at all pain more like how we look at how we look at headaches sometimes I'll explain back pain that way that's more helpful to think about it like a headache in your back because it's probably not a damage type thing, and it probably has a lot more to do with many broader contributing factors. So yeah, I mean, even just like a heart attack,

your heart's literally dying and the damage is at your heart specifically, but where do people feel symptoms? Goes up into their neck, goes down their left arm. I don't have damage in those areas, but that's where pain is. There's so many mismatches that you can kind of go over.

It's interesting. I feel like, again, like just kind of in the wellness world, especially like people just want to find things to fix too. And I feel like if you're always looking for something to fix, like you're always going to feel like something is wrong with you. And I feel like we're made to feel like there's something wrong with us, obviously, because that's how the industry profits. Yeah, well, you look at, I mean, look at a visit.

Like I think the saddest thing that I ever see, I don't do this anymore, but I used to do this when I was even more angry and spiteful. I would go on like chiropractic and physical therapy websites. you look at their reviews from patients. And it would literally like break my heart and kill me inside a little bit. I would read patients saying, wow, I never would have known how much is so wrong with me. I'm so thankful that I got in there so they could show me. And I'm like, oh my God, we literally have people thanking us for making them feel like their body is just trash.

And then when you look at a lot of the things that we're labeling on these people and saying is dysfunctional or damaged or messed up or bad or wrong, a lot of it's just normal shit that's not strongly correlated with pain and it's in a lot of pain-free people too and it can't explain a pain situation but we'll still not read enough research and give those explanations and literally people will come in with one problem and leave with 10 and we make people feel more broken and that's a huge problem for again my patient demographic being persistent pain Like, you see one of the biggest drivers of a pain experience and things that make pain burdensome.

It's not really the pain itself. Like, yeah, pain sucks, but everybody's got some degree pain day to day. There's more to it that makes a pain experience truly like half for people. And a lot of that has to do with the things it takes away from you. And like the way it changes the way you see yourself, that's what drives the burden a lot of the time. Because in those people dealing persistent pain, like they're so convinced that they're back. is trash or whatever, that they stop doing a lot of the things that they love to do. And what's really shitty about a lot of those avoidance situations and people becoming very

overprotective in those instances is it can be avoided if people are just given better advice and given better guidance and better information up front and not told all these things about how their disc is ready to slip out of their back and how they should never bend over or deadlift again and always keep your back straight, always sit. up straight, protect, protect, protect. I mean, we have whole papers that are written and published about how some percentage of this chronic back pain problem that we have across the globe is partially iatrogenic, meaning clinician caused. Like, we cause it with the bad advice and the bad explanations that we give to people. We cause disability that way. So it's pretty shitty. It's really

bad. Yeah. This is another thing that I've talked to you about, but can you speak to like tech neck and tech back, how much are we attributing back issues, neck issues, posture issues to technology and how accurate or not is that? People who follow me and like my stuff love to like fuck me and tag me in every tech neck and posture video ever because they know how much I hate that bullshit. It's just so insane to me because one, like now at this point, you know, first of all, like the idea in and of itself is silly for a lot of reasons. touch on that. But we have enough publications now. We're like, it's very, very clear.

Tech neck and Tex-neck is not a thing. Cell phone usage, forward head posture, you know, having your chin out a little bit and looking down a lot and using your phone a lot, they're not correlated with neck pain. They're not predictive neck pain. I can't look at somebody who's looking down at their phone a whole hell of a lot all day every day and say they're going to get neck pain because it doesn't have that predictive value. It's not a risk for developing neck pain symptoms. I'm worried about wrinkle. I can't speak to that because that's out of my expertise. But it's just like it's so insane to me because like, okay, if Technic was a problem,

like it's not like I know cell phones are new, but it's not like this is the first thing that humans have ever looked down at for a long period of time. Like where was newspaper neck and where was, you know, sit in a cave and stare at a fire neck and like all the, like it's just so fucking stupid how we're willing to convince people that they're trashing their spines by using their fog. phone. Like, how are you supposed to live? People live on their cell phones. And then the advice, that's what kills me. The advice we give. Like, not only you're going to be just outright wrong

and tell them they have tax snack, which is already just stupid, but then you're going to give them this horribly useless advice where you tell them to hold their phone up to their face and they use it, you really expect people. Like, they're going to waddle into traffic. They look like they're walking around filming people and taking photos. Like, when people do that, you're making them look like an alien, playing a human or something like that. Like, it's like he's trying to play. It's just so ridiculous to me. Like, not only is the information bad,

but then the advice for the bad information is just also shit. It's just so it's ridiculous. Just an argument for having like a chip implanted so that we can just see it instead of having to look down at our phone. I guess, I mean, as you can tell, anything that gets rid of tech snack or tech neck or all those posthumists at this point, I'm for it.

Like the posture thing, I work with people every single day who they've had a persistent back pain for so long. And everybody they've talked to has told them that their posture is part of it because they don't sit up straight. And they've literally like made such a habit out of forcing themselves into this naturally uncomfortable position that aggravates their symptoms. But they won't even recognize that it aggravates their symptoms. and they'll persist through it because they've had that message reinforced a billion times that it's supposed to help them and that if they don't do it, it'll only get worse.

And like, I literally, like, I spend so much of my time helping people unlearn that stuff and try to break those habits. And, like, it's shockingly hard. If you've had somebody who's enforcing themselves with their painful, sensitive back, to sit up straight, keep their core tight, like some people, like, forget how to not do that,

it becomes so ingrained and they're so fearful of aggravating or worsening their symptoms. It's like it's crazy that we make people move like these like robots almost. You know, it's it's just ridiculous. But no, I tell people slouch all the fucking time. You can do it. You're capable of it. So it's not like you weren't meant to do. It's more comfortable.

So it's okay to slouch. I've slouched this entire interview. I'm sure you have to, as you should. You do. I'm like punch over. As you know, I'm sitting on a. the floor right now. As you should be.

That's what humans do. It's normal. This is what we did when we were crouched over the fire. You're right. I like that. It's normal. What are some other

very egregious kind of wellnessy claims that you've seen that people should be wary of? There are so many big ones that aren't like super egregious that I have more than enough to focus on that. Like if you watch my post,

like I don't really talk about like the really crazy ones that often because there's just so many, like, there's so many big myths that don't even seem that crazy to people that deserve so much more attention. But, I mean, there's still stuff about, like, how us treating babies and how, like, being born as traumatics, you need a chiropractor to crack your back and, like, maintenance care with spinal manipulation and how, like, you need to go in, you know, regularly as, like, we love chiropractors. We were taught this in school too in like business courses that we're supposed to try and present ourselves to patients like like dentists do and say like well you see your dentist you know once or twice a year for

your your oral hygiene so you need to see your chiropractor once or twice a year for your spine hygiene as if like cracking your back like cleans your fucking spine or something like that I don't it's it's true I mean there's so many of them you could go in any direction and I'd what I said to Danielle too. I was like, the amount, you could do a whole two-hour episode just in musculoskeletal myths alone, whether it's impingments or disc bulges or posture or, you know, even for like the running community, like different running myths about gait and how people are supposed to move like everywhere you look within musculoskeletal health care. It's just such a huge, huge mess. That's a, I guess, fortunately for me, I'd never run out of content to me. I'd never run out of

content to make, but God, it sure gets depressing some days and you're like, everything's wrong all the time. It's tough. I think it's tough for everybody. I think it's tough for the patient. Like, I'm thinking of just in my experience, something that was so hard for me, which I've talked about on Instagram. I developed really bad tinnitus a couple years ago. And I think it was post-viral. It was really the only thing that we could like attribute it to. I had a bad virus. and then I flew and they thought maybe it went to my ear. I don't know. The only thing that I have found to help has been acupuncture,

but I'm very aware. I'm like, I think it's like the acupuncture is relaxing. And there are so many studies around tinnitus that, you know, they really don't have any kind of cure or treatment. However, it seems to be exacerbated by stress. And so obviously, like to counter that stress do things that are relaxing. and that seems to kind of alleviate people's symptoms. But I was desperate.

Like I was willing to do anything. And when I found the acupuncture, I was like, yeah, this seems to actually work for me. So I think I can understand how somebody would be in the headspace where they're like in so much pain or uncomfortable or whatever. And they feel like we were talking about in the beginning, whether it's a placebo effect or what, they feel like it's actually helping them.

I mean, there's a way to do that, though. There's a way to do that for people and still offer services like that. for people for those problems that don't seem to have anything else helpful. Like, there's an honest way to do it. That's, that's where I would like, you know, because people would probably look at a lot of my content and be like, content and be like, he'd never be okay with something like that. But like I've done posts before where, you know, for chronic migraine,

like that's a tricky one to find help for. A lot of people are pretty much just told right away, like, we don't know what to do about this. And they can't find anything useful. And they try and try and try. and like I've had conversation with people who swear by spinal manipulation or specifically neck cracking for their migraine. And I'm somebody who has advocated that we not do neck cracking as a profession at all anymore

because the risk not being justified by the minimal benefit. And yet you'll hear me say that, but I'll still say for like somebody with chronic migraine, it's so hard to find something that's useful. And if the neck cracking is the one thing that you've found that helps you, you should absolutely fucking do it. But I just, in those situations, then I just hope that the provider is being responsible and not telling the patient that it's helpful because their necks misaligned or because their joints are restricted or anything ridiculous like that. If you can provide that relief for them and also just be open and honest about it, I mean, I tell providers all the time, too,

when I do like teaching stuff with students, like, it's okay to tell patients that we don't know what's driving an effect too. Patients appreciate that transparency. There's times when we have to tell patients that we don't know exactly what the problem is, but we can tell them what it's not to at least reassure them. There's times when we can say, like, I don't know if this will help or not. It doesn't have any studies to say that it's effective, but it's relatively safe if you'd like to try it.

Like that's an okay way to communicate that without making somebody think that their neck is misaligned, and that's why they have chronic migraine. So that's the only thing that I would say there. Like if we just clean up the communication, I wouldn't have so much stuff to yell about all the time. Well, your yelling is very entertaining. You have amazing videos on TikTok and Instagram. Why don't you tell everybody where they can find you?

And then also if they want to work with you, if you're taking remote, where everyone can find that information too. Sure. So it's just Aaron underscore Kubal on all the social media, at Instagram, TikTok, Twitter. Sometimes there's a DC at the end, as in doctor, chiropractic, sometimes there's not.

But it's always Aaron Kubal's, if you look that up, they'll find me. And then I'm horrible with DMs. I kind of gave up on those for the most part. So if somebody really needs to reach me, as far as like questions or patient stuff, if they want to work with me or whatever, just my email, Aaron Kubal, DC at gmail.com is good.

And then my website for my clinic, it's linked in all my social media bios. So if you go there and you want to look into what I actually do with patients or booking and all that fun stuff, I can go check that out. But yeah, I think that's all of it. That's all I do. We can link everything. So it's easy. Nice.

Thank you so much for coming on. Absolutely. Thanks for having me. This was a good one. I hope you enjoyed that episode. If you liked it and if you like the show in general, please take a second to rate, review, and subscribe. It goes a long way, and it's actually the best way to support the show. Also, if you want to see more about each episode, you can head over to The Blond Files podcast on Instagram. I'm always posting about each episode there or over on my personal page at Ariel Laurie.